Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings...
-
Upload
kelly-stone -
Category
Documents
-
view
219 -
download
0
Transcript of Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings...
![Page 1: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/1.jpg)
Evaluation of Wet Mount and KOH Preparations
Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of
Vicriviroc (MK-4176) and MK-2048 MTN-028 Study Specific Training
![Page 2: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/2.jpg)
Wet Mount for Clue Cells and Trichomonas
• Remove the swab from the tube with saline and dot a liberal amount onto a glass slide
• Place a coverslip over the specimen• Scan the slide on 100X and 400X
– Positive for clue cells: >20% – Negative for clue cells: <20% – Positive for Trichomonas: any motile trichomonads seen– Positive for yeast: any budding yeast and/or pseudohyphae
seen
![Page 3: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/3.jpg)
KOH preparation for Yeast
• Place a coverslip over the KOH preparation after smelling for amine odor
• Scan the slide at 100X and 400X – Positive for yeast: any budding yeast and/or
pseudohyphae– Negative for yeast: no yeast cells seen on slide
![Page 4: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/4.jpg)
Gram stain of vaginal flora
Normal flora BV
![Page 5: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/5.jpg)
Wet Mount Evaluation
• Minimum of 5 fields should be evaluated.• Ask yourself: What is your first impression?• Assess the epithelial cells and background
bacteria present.Shape: Symmetrical rods or pleomorphic coccobacillary?Numbers: Fewer or many?
![Page 6: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/6.jpg)
Normal flora: No clue cells
400X1000X
![Page 7: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/7.jpg)
BV: clue cells and WBC
400X1000X
![Page 8: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/8.jpg)
BV: Clue cells
400X1000X
![Page 9: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/9.jpg)
Wet Mount Evaluation: Clue Cells• The following tips should be utilized for determining clue
cells:
1. Count the number of distinguishable epithelial cells in your field of view.
2. To determine if any of the epithelial cells are clue cells, it is important to study ONLY THE BORDERS OF THE CELL.Note: Normal variation in cell membranes can result in a “grainy” appearance of the cell and can mimic bacterial adhesion.
3. To determine the percentage of clue cells in your field:a. Count the number of clue cells and divide that number by
the total number of distinguishable epithelial cells.
![Page 10: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/10.jpg)
Normal Cells Clue Cells
400X 400X
![Page 11: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/11.jpg)
Normal Cells Clue Cells
400X 400X
![Page 12: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/12.jpg)
Clue Cells
400X
![Page 13: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/13.jpg)
Normal Cells Normal Cells and yeast
400X 400X
![Page 14: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/14.jpg)
Wet Mount Evaluation: Yeast
• Determining Yeast in Wet Mounts or KOH preps• In order for yeast/pseudohyphae not to be mistaken
for amorphous material, nuclei or artifacts there must be “budding”.
“Bud”
Pseudohyphae with “buds”
![Page 15: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/15.jpg)
Pseudohyphae
Budding yeast
400X
![Page 16: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/16.jpg)
Budding yeast
400X
![Page 17: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/17.jpg)
Pseudohyphae and budding yeast
Budding yeast
KOH 400X KOH 400X
![Page 18: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/18.jpg)
Pseudohyphae and budding yeast
Pseudohyphae, budding yeast and
amorphous material
KOH 400X KOH 400X
![Page 19: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/19.jpg)
Pseudohyphae, budding yeast and
amorphous material
Budding yeast
KOH 400X KOH 400X
![Page 20: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/20.jpg)
Amorphous material Amorphous material
KOH 400X KOH 400X
![Page 21: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/21.jpg)
Amorphous material Amorphous material
KOH 400X KOH 400X
![Page 22: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/22.jpg)
Pseudohyphae, budding yeast and
amorphous material
Pseudohyphae and budding yeast
KOH 400X KOH 400X
![Page 23: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/23.jpg)
Wet Mounts: Other Common Morphotypes
Trichomonas vaginalis Neutrophils
Sperm Red blood cells
![Page 24: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/24.jpg)
Epithelial Count = 8
Clue Cells = 3(38%)
BV MorphotypeDominatedFlora
![Page 25: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/25.jpg)
Clue Cell NegativeEpithelial Count = 4
![Page 26: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/26.jpg)
Epithelial Count = 6
Clue Cell Negative
Mixed Flora
![Page 27: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/27.jpg)
Epithelial Count = 11
Clue Cell = 3(27%)
![Page 28: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/28.jpg)
Budding yeast
![Page 29: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/29.jpg)
Artifact
Pseudohyphae
“Bud”
![Page 30: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/30.jpg)
artifact
RBCs
WBC covered with bacteria
Clue cell
![Page 31: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/31.jpg)
Microstructures of leaves called stellate hairs found in a vaginal KOH prep
![Page 32: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/32.jpg)
Know Your Microscope
![Page 33: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/33.jpg)
Adjusting the Condenser for Contrast of Cells
Move the condenser up and down
![Page 34: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/34.jpg)
Adjustments for Optimal Illumination
Adjust condenser aperture diaphragm
Centers the condenser
Adjust light source diaphragm
![Page 35: Evaluation of Wet Mount and KOH Preparations Phase 1 Pharmacokinetic Trial of Two Intravaginal Rings (IVRs) Containing Different Dose Strengths of Vicriviroc.](https://reader035.fdocuments.us/reader035/viewer/2022062314/56649ed35503460f94be3e1b/html5/thumbnails/35.jpg)
Care and Cleaning of Microscope
• Cover the scope when not in use• Use water or mild cleaning solutions for the body of
the scope• Clean the lenses with optics cleaning paper, Kimwipes,
or a cotton cloth (do not use facial tissue)• Use an optics cleaning solution to remove oily or
greasy dirt (fingerprints, immersion oil)• Check the alignment of the condenser with “Kohler
illumination”